Mp57-17 Myurology Health: Implementation of a Novel Episode Based Payment Model for Nephrolithiasis

You have accessJournal of UrologyHealth Services Research: Value of Care: Cost and Outcomes II (MP57)1 May 2024MP57-17 MYUROLOGY HEALTH: IMPLEMENTATION OF A NOVEL EPISODE BASED PAYMENT MODEL FOR NEPHROLITHIASIS Kate Dwyer, Ruchika Talwar, Jackson Cabo, Brittany L. Cunningham, Chelsea Parris, C. J. Stimson, Sabrina J. Poon, and Ryan S. Hsi Kate DwyerKate Dwyer , Ruchika TalwarRuchika Talwar , Jackson CaboJackson Cabo , Brittany L. CunninghamBrittany L. Cunningham , Chelsea ParrisChelsea Parris , C. J. StimsonC. J. Stimson , Sabrina J. PoonSabrina J. Poon , and Ryan S. HsiRyan S. Hsi View All Author Informationhttps://doi.org/10.1097/01.JU.0001009420.83948.eb.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Value-based payment (VBP) implementation has been a priority in healthcare, but applications in urology have been limited. Herein, we describe a single academic institution's experience with a direct-to-employer bundled program, "MyUrology Health," covering all nephrolithiasis care for a single prospective price with zero patient-facing costs, including repeat procedures and emergency visits, irrespective of volume of services utilized. METHODS: Eligible patients from two self-insured employers were enrolled prospectively from 1/2023-9/2023 under one of four tiers (Figure 1). For those managed non-surgically, EOC ended 100 days after enrollment. For those managed surgically, EOC ended 6 months after first procedure. Clinic and emergency visits, imaging/laboratory testing related to nephrolithiasis and dietician consultation were included in the EOC. We analyzed short-term clinical and quality outcomes. RESULTS: In total, 60 patients were enrolled (Table 1): 97% had a health system sponsored health plan. Less than 5% of patients had a high-deductible plan. 73% were enrolled at the time of a symptomatic stone episode; most opted for the trial of passage (40%) or single endoscopic tier (48%). Over half (60%) received surgery within a mean of 30 days from EOC start. Of those who required intervention, 7 had urgent procedures prior to the initiation of the EOC. Postoperatively, 34/36 patients had imaging ordered, with 30 completing it (83%). 31 patients completed a 24-hour urine analysis and 7 saw a dietician. Ten emergency visits fell within the EOC. CONCLUSIONS: Under MyUrologyHealth, the first-ever VBP for nephrolithiasis, 95% had zero out-of-pocket expenses for their EOC. This included comprehensive services including surgery if indicated, provider visits, and stone prevention care. Future analyses will provide insight into the overall cost and quality implications of this novel VBP model. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e944 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Kate Dwyer More articles by this author Ruchika Talwar More articles by this author Jackson Cabo More articles by this author Brittany L. Cunningham More articles by this author Chelsea Parris More articles by this author C. J. Stimson More articles by this author Sabrina J. Poon More articles by this author Ryan S. Hsi More articles by this author Expand All Advertisement PDF downloadLoading ...